Individual
PAULA BLOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1227
(304) 388-4170
Mailing address
3200 MACCORKLE AVENUE SE, EMERGENCY DEPARTMENT, CHARLESTON, WV 25304
(304) 388-4172
(304) 388-4155
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00521
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718072
WV BCBS
WV
01
—
1069532
WV DWC
WV
Enumeration date
12/19/2005
Last updated
09/25/2024
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